台灣老人福利機構與長期照顧資源分配之探討

A Study on the Welfare Organization of the Elderly in Taiwan and the Distribution of Long - term Care Resources

林莉雅(Li-Ya Lin)

指導教授 ： 田峻吉

淡江大學/商管學院/保險學系保險經營碩士班/碩士(2017年)

https://doi.org/10.6846/TKU.2017.00499

摘要

台灣人口高齡化問題日益嚴重，在高齡社會下，政府如何有效率分配長期照顧資源將是非常重要的議題。本文利用台灣人口結構資料與老人福利機構分佈資料，探討高齡人口與長期照顧資源分佈之間的關係。本研究人口資料來源與老人福利機構分佈資料分別可由內政部資料開放平台與衛生福利部取得。本文利用老人福利機構資料，分別計算各縣市老人福利機構的長照床、養護床與安養床的分佈狀況。然後將長期照顧資源分佈資料結合人口結構資料，將長照床、養護床與安養床數目除以各縣市高齡人口之比率，排序整理後可計算吉尼係數(Gini coefficient)。
本文實證結果發現， 65歲以上高齡人口比例較高的縣市多集中於南部，分別為嘉義縣(17.90%)、雲林縣(17.09%)、南投縣(15.86%)、台北市(15.55%)與屏東縣(15.20%)；65歲以上高齡人口比例較低的縣市則為桃園市(10.216%)，其次為連江縣(10.218%)、台中市(10.91%)、新竹市(11.01%)與金門縣(11.67%)。總床數與養護床數之吉尼係數分別為0.16089與0.16622，兩者之數值皆不高，顯示各縣市之總床數與養護床數資源分佈情形尚屬平均，資源分配差距並不大。長照床數與安養床數之吉尼係數分別為0.54656與0.49113，兩者之吉尼係數較大，顯示長照床數與安養床數資源分佈不均之情形較為嚴重。因此，此等分佈不平均之情形皆有待做更進一步之調整，對於資源較匱乏之地區進行增設，方能使長照床數與安養床數資源做更好的利用。

關鍵字

長期照顧 ； 吉尼係數 ； 老人福利機構

並列摘要

The problem of aging population in Taiwan is becoming more and more serious. How can the government allocate long-term care resources effectively in an aging society has become a very important agenda. This paper uses the data relating to Taiwan's population structure and the welfare agencies of the elderly to investigate the relationship between the elderly population and the long-term care resources distribution. The information of the population data and the distribution of the welfare agencies for the elderly can be obtained from the Ministry of Interior Information Open Platform and the Ministry of Health and Welfare. This paper uses the information of the elderly welfare agencies to calculate the distribution of the long-term care bed, the conservation bed and the security bed in the welfare institutions of the counties and cities. The number of long-term care beds, the number of conservation beds, the number of security beds, and the aging population in the counties and cities can be obtained from the information of resource distribution of long-term care and the population structure data. Then, the Gini coefficient can be acquired from sorting out the ratios of dividing the number of long-term care beds, the number of conservation beds and the number of security beds of each counties and cities by its respective aging population.
According to the empirical research results, it is found that the counties and cities with high proportion of the elderly over 65 are concentrated in the south, namely, Chiayi County (17.90%), Yunlin County (17.09%), Nantou County (15.86%), Taipei City (15.55% ) and Pingtung County (15.20%).While counties and cities with lower proportion of the population over the age of 65 are Taoyuan City (10.216%), Lianjiang County (10.218%), Taichung (10.91%), Hsinchu (11.01%) and the Kinmen County (11.67 %), respectively. The Gini coefficients of the total number of beds and the number of conservation beds are 0.16089 and 0.16622 respectively, and the values of the total number of beds and the number of conservation beds are not high, indicating that the total number of beds and the number of the conservation beds are still averaged and the resource allocation gap is not large. The Gini coefficients of the number of long-term care beds and the number of security beds are 0.54656 and 0.49113 respectively. The value of these two Gini coefficients is larger, which shows that the number of long-term care beds and the number of security beds are relatively uneven. Therefore, the situation in which these distributions are uneven is subject to further adjustments. For the areas where the resources are scarce, it is necessary to increase the number of conservation beds and security beds in order to better utilize the resources.

並列關鍵字

Long-term care ； Gini coefficient ； elderly welfare agencies

參考文獻

38. 謝明瑞、周信佑(2016)，財團法人國家政策研究基金會，長照保險制與長照稅收制之比較分析。

7. 王增勇(2011)，家庭照顧者做為一種改革長期照顧的社會運動，台灣社會研究季刊八十五期，第397-414頁。

16. 吳淑瓊(2004)，從「建構長期照護體系先導計畫」之執行看 我國社區式長期照護體系之建構，社區發展季刊106期，第88頁。

1. Blumenthal, S, Kagen J., “ The effects of socioeconomic status on health in rural and urban America” , JAMA, 2002, 287: 109.

2. Colombo, F et al. (2011). Help wanted? Providing and Paying for Long-Term Care, OECD Health Policy Studies, OECD Publishing. p 39-40.